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目的探讨钙敏感受体(CaR)在继发性甲状旁腺功能亢进(SHPT)患者甲状旁腺组织中的表达及其在发病机制中的作用。方法采用免疫组化二步法对14例继发性甲状旁腺增生及8例正常甲状旁腺的石蜡标本进行CaR检测。结果14例甲状旁腺增生患者的切片中均可见到CaR阳性细胞,CaR阳性率平均为(20.816±3.41)%,其中8例结节性增生(NH)的CaR阳性率平均为(16.75±1.38)%,6例弥漫性增生(DH)病例为(28.16±2.16)%。结论CaR阳性表达的减少与甲状旁腺组织增生密切相关,甲状旁腺增生组织中的表达明显低于正常甲状旁腺组织;而在NH和DH中,以NH组表达减少更为显著。慢性肾功能衰竭所导致的CaR抑制,是引起SHPT的重要原因。
Objective To investigate the expression of calcium sensitive receptor (CaR) in parathyroid tissue of patients with secondary hyperparathyroidism (SHPT) and its role in pathogenesis. Methods The immunohistochemical two-step method for 14 cases of secondary hyperplasia of parathyroid and paraffin specimens of 8 cases of normal parathyroid CaR detection. Results CaR positive cells were found in all the 14 cases of hyperplasia of parathyroid gland. The average positive rate of CaR was (20.816 ± 3.41)%, and the average positive rate of CaR in 8 cases of nodular hyperplasia (NH) was (16.75 ± 1.38 )%, Six cases of diffuse hyperplasia (DH) cases (28.16 ± 2.16)%. Conclusions The decrease of CaR positive expression is closely related to the hyperplasia of parathyroid tissue and the expression of parathyroid hyperplasia tissue is obviously lower than that of normal parathyroid tissue. However, in NH and DH, the expression of CaR in NH group is more obvious. Chronic renal failure caused by CaR inhibition, is an important cause of SHPT.